MANAGING AND IMPROVING QUALITY 77
Risk Management Risk management is a component of quality management, but its purpose is to identify, analyze, and evaluate risks and then to develop a plan for reducing the frequency and severity of accidents and injuries. Risk management is a continuous daily program of detection, education, and intervention.
A risk management program involves all departments of the organization. It must be an organization-wide program, with the board of directors’ approval and input from all depart- ments. The program must have high-level commitment, including that of the chief executive officer and the chief nurse.
A risk management program:
1. Identifies potential risks for accident, injury, or financial loss. Formal and informal communication with all organizational departments and inspection of facilities are essential to identifying problem areas.
2. Reviews current organization-wide monitoring systems (incident reports, audits, committee minutes, oral complaints, patient questionnaires), evaluates completeness, and determines additional systems needed to provide the factual data essential for risk management control.
3. Analyzes the frequency, severity, and causes of general categories and specific types of incidents causing injury or adverse outcomes to patients. To plan risk intervention strategies, it is necessary to estimate the outcomes associated with the various types of incidents.
4. Reviews and appraises safety and risk aspects of patient care procedures and new programs.
5. Monitors laws and codes related to patient safety, consent, and care.
6. Eliminates or reduces risks as much as possible.
7. Reviews the work of other committees to determine potential liability and recommend prevention or corrective action. Examples of such committees are infection, medical audit, safety/security, pharmacy, nursing audit, and productivity.
8. Identifies needs for patient, family, and personnel education suggested by all of the foregoing and implements the appropriate educational program.
9. Evaluates the results of a risk management program.
10. Provides periodic reports to administration, medical staff, and the board of directors.
Nursing’s Role in Risk Management In the organizational setting, nursing is the one department involved in patient care 24 hours a day; nursing personnel are therefore critical to the success of a risk management program. The chief nursing administrator must be committed to the program. Her or his attitude will influence the staff and their participation. After all, it is the staff, with their daily patient contact, who actu- ally implement a risk management program.